决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:First-line Therapy in Newly Diagnosed Multiple Myeloma.
未标注:一线多发性骨髓瘤治疗已从美法仑-泼尼松方案演进为包含蛋白酶体抑制剂、免疫调节药物、抗CD38单克隆抗体和自体干细胞移植的四联方案,显著改善了生存。
未标注:一线多发性骨髓瘤治疗已从美法仑-泼尼松方案演进为包含蛋白酶体抑制剂、免疫调节药物、抗CD38单克隆抗体和自体干细胞移植的四联方案,显著改善了生存。本综述总结了新诊断多发性骨髓瘤风险分层和治疗的当前方法,并强调可测量残留病灶适应性策略的新兴作用。我们还讨论了近期将CAR-T 细胞和双特异性抗体整合到一线治疗中的努力。随着生物学驱动策略的进展,部分患者可能实现持久的无治疗缓解。正在进行的研究将阐明如何在平衡疗效、毒性和生存质量的同时,最佳地个体化治疗,以迈向功能性治愈。意义:尽管取得了前所未有的进展,多发性骨髓瘤治疗在很大程度上仍趋于统一,并强调无限期治疗。在此,我们在总结当前标准治疗的同时,倡导基于疾病生物学、治疗反应和新兴生物标志物的个体化方法。整合免疫疗法的新型策略正在为部分患者实现无治疗缓解和功能性治愈铺平道路。
UNLABELLED: First-line multiple myeloma treatment has evolved from melphalan-prednisone to quadruplet regimens incorporating proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, and autologous stem cell transplantation, yielding significantly improved survival. This review summarizes current approaches to risk stratification and therapy for newly diagnosed multiple myeloma and highlights the emerging role of measurable residual disease-adaptive strategies. We also discuss recent efforts to integrate chimeric antigen receptor T cells and bispecific antibodies into up-front treatment. As biology-driven strategies advance, select patients may achieve durable treatment-free remissions. Ongoing studies will clarify how to best tailor therapy while balancing efficacy, toxicity, and survivorship toward functional cures. SIGNIFICANCE: Despite unprecedented advances, multiple myeloma therapy remains largely uniform and emphasizes indefinite treatment. Herein, although summarizing current standard-of-care therapy, we advocate for individualized approaches informed by disease biology, treatment response, and emerging biomarkers. Novel strategies incorporating immunotherapies are paving the way toward treatment-free remissions and functional cures in select patients.
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